Financial cost of vaccine waste in the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil

Authors

DOI:

https://doi.org/10.21674/2448-0479.71.131-141

Keywords:

Vaccine, Waste, Health economics, Public administration

Abstract

The National Immunization Program of Brazil is an international reference, due to the large offer of immunobiologicals for the population, intended for different age groups in a public and free. With the significant increase in public investments in this area, this study aims to estimate the rates of loss and use of doses of vaccines from multidose and single-dose vials in the Metropolitan Region of Porto Alegre, Rio Grande do Sul, from 2015 to 2017. The methodology of this descriptive study was carried out using secondary data from Information System of the National Immunization Program and Strategic Inputs Information System  Nine vaccines were studied, with an average waste of 962,013 doses, which represents approximately R $ 3.5 million, that is, more than US$ 700.00. For multidose vaccines, the average waste (R $ 1,079,143) was four times greater than acceptable (R $ 269,785). For single-dose vaccines (R $ 1,298,159) it was twenty times higher (R $ 64,908). Thus, the costs of wasting vaccine doses 44.7% have been a burden on public resources that can invest in improvements in the health system.

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Author Biographies

Scheila Mai, Universidade Federal do Rio Grande do Sul-UFRGS

http://lattes.cnpq.br/1423151487329413

Roger Rosa dos Santos, Universidade Federal do Rio Grande do Sul (UFRGS)

http://lattes.cnpq.br/6601104117405392

Fábio Herrmann, Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS)

http://lattes.cnpq.br/9360508932497513

Adriane da Silva Carvalho, Universidade Federal do Rio Grande do Sul (UFRGS)

http://lattes.cnpq.br/8653801351505877

Vania Celina Dezoti Micheletti, Universidade do Vale do Rio do Sinos (UNISINOS)

http://lattes.cnpq.br/1661437592439970

Ronaldo Bordin, Universidade Federal do Rio Grande do Sul (UFRGS)

http://lattes.cnpq.br/6909911499178658

References

ASSI, Tina-Marie; BROWN, Shawn T; DJIBO, Ali; A NORMAN, Bryan; RAJGOPAL, Jayant; WELLING, Joel s; CHEN, Sheng-I; BAILEY, Rachel R; KONE, Souleymane; KENEA, Hailu. Impact of changing the measles vaccine vial size on Niger's vaccine supply chain: a computational model. Bmc Public Health, [S.L.], v. 11, n. 1, p. 1-9, 2 jun. 2011. Springer Science and Business Media LLC. Disponível em: http://dx.doi.org/10.1186/1471-2458-11-425. Acesso em: 02 jun. 2020.

BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de Imunizações: 30 anos. Brasília: Ministério da Saúde, 2003.

______. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Programa Nacional de Imunizações (PNI): 40 anos. Brasília: Ministério da Saúde.

______. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação em Saúde. Saúde Brasil 2012: uma análise da situação de saúde e dos 40 anos do Programa Nacional de Imunizações. Brasília: Ministério da Saúde, 2013b.536p.

______. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Manual de Normas e Procedimentos para Vacinação. Brasília: Ministério da Saúde, 2014.

DHAMODHARAN, Aswin; PROANO, Ruben A. Determining the optimal vaccine vial size in developing countries: a Monte Carlo simulation approach. Health Care Management Science, [S.L.], v. 15, n. 3, p. 188-196, 19 abr. 2012. Springer Science and Business Media LLC. Disponível em: http://dx.doi.org/10.1007/s10729-012-9200-4. Acesso em: 09 ago. 2020.

DIAS, Barbara. Relação entre perdas vacinais e variáveis de infraestrutura em salas de vacinação de uma cidade do Sudeste brasileiro (Dissertação). Rio de Janeiro: Universidade Federal do Rio de Janeiro. 2016.

DRAIN, Paul.; NELSON, Carib.; LLOYD, Johs S. Single-dose versus multi-dose vaccine vials for immunization programmes in developing countries. Bulletin of the World Health Organization: the International Journal of Public Health, 281(‎10)‎ : 726-731. Disponível em: https://apps.who.int/iris/handle/10665/72063. Acesso em: 09 ago. 2020.

GANDHI, Gian; LYDON, Patrick; CORNEJO, Santiago; BRENZEL, Logan; WROBEL, Sandra; CHANG, Hugh. Projections of costs, financing, and additional resource requirements for low- and lower middle-income country immunization programs over the decade, 2011–2020. Vaccine, [S.L.], v. 31, p. 137-148, abr. 2013. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/j.vaccine.2013.01.036. Acesso em: 09 ago. 2020.

GAVI ALLIANCE. Report to the GAVI alliance board 18–19 June 2014 - GAVI Alliance immunisation supply chain strategy, 2014. Disponível em: https://www.gavi.org/sites/default/files/board/minutes/2014/18-june/05%20-%20GAVI%20Alliance%20immunisation%20supply%20chain%20strategy%20document.pdf. Acesso em: 13 ago. 2020.

GUICHARD, Stephane; HYMBAUGH, Karen; BURKHOLDER, Brent; DIORDITSA, Serguei; NAVARRO, Christine; AHMED, Selina; RAHMAN, Mohd. Mahbubur. Vaccine wastage in Bangladesh. Vaccine, [S.L.], v. 28, n. 3, p. 858-863, jan. 2010. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/j.vaccine.2009.08.035. Acesso em: 09 ago. 2020.

HEATON, Alexis; KRUDWIG, Kirstin; LORENSON, Tina; BURGESS, Craig; CUNNINGHAM, Andrew; STEINGLASS, Robert. Doses per vaccine vial container: an understated and underestimated driver of performance that needs more evidence. Vaccine, [S.L.], v. 35, n. 17, p. 2272-2278, abr. 2017. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/j.vaccine.2016.11.066. Acesso em: 02.ago. 2020.

HOMMA, Akira; MARTINS, Reinaldo de Menezes; LEAL, Maria da Luz Fernandes; FREIRE, Marcos da Silva; COUTO, Artur Roberto. Atualização em vacinas, imunizações e inovação tecnológica. Ciência & Saúde Coletiva, [S.L.], v. 16, n. 2, p. 445-458, fev. 2011. FapUNIFESP (SciELO). Disponível em: http://dx.doi.org/10.1590/s1413-81232011000200008. Acesso em: 02. ago. 2020.

LEE, Bruce Y.; NORMAN, Bryan A.; ASSI, Tina-Marie; CHEN, Sheng-I; BAILEY, Rachel R.; RAJGOPAL, Jayant; BROWN, Shawn T.; WIRINGA, Ann E.; BURKE, Donald S.. Single versus multi-dose vaccine vials: an economic computational model. Vaccine, [S.L.], v. 28, n. 32, p. 5292-5300, jul. 2010. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/j.vaccine.2010.05.048. Acesso em: 25. jul. 2020.

LEE, Bruce Y.; ASSI, Tina-Marie; ROOKKAPAN, Korngamon; CONNOR, Diana L.; RAJGOPAL, Jayant; SORNSRIVICHAI, Vorasith; BROWN, Shawn T.; WELLING, Joel S.; NORMAN, Bryan A.; CHEN, Sheng-I. Replacing the measles ten-dose vaccine presentation with the single-dose presentation in Thailand. Vaccine, [S.L.], v. 29, n. 21, p. 3811-3817, maio 2011. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/j.vaccine.2011.03.013. Acesso em: 25. jul. 2020.

KAMARA, L.; LYDON, P.; BILOUS, J.; VANDELAER, J.; EGGERS, R.; GACIC-DOBO, M.; MEANEY, W.; OKWO-BELE, J.-M.. Global Immunization Vision and Strategy (GIVS): a mid-term analysis of progress in 50 countries. Health Policy And Planning, [S.L.], v. 28, n. 1, p. 11-19, 12 mar. 2012. Oxford University Press (OUP). Disponível em: http://dx.doi.org/10.1093/heapol/czs020. Acesso em: 25. jul. 2020.

LYDON, Patrick; GANDHI, Gian; VANDELAER, Jos; OKWO-BELE, Jean-Marie. Health system cost of delivering routine vaccination in low- and lower-middle income countries: what is needed over the next decade?. Bulletin Of The World Health Organization, [S.L.], v. 92, n. 5, p. 382-384, 7 fev. 2014. WHO Press. Disponível em: http://dx.doi.org/10.2471/blt.13.130146. Acesso em: 11. jul. 2020

MAI, Scheila et al. Utilização e perda de doses de vacinas na Região Metropolitana de Porto Alegre, Rio Grande do Sul: um estudo descritivo de 2015-2017*. Epidemiologia e Serviços de Saúde, [S.L.], v. 28, n. 3, p. 1-12, fev. 2020. Disponível em: https://www.scielo.br/scielo.php?pid=S2237-96222019000300309&script=sci_arttext. Acesso em: 13 ago. 2020.

MOFRAD, Maryam H.; MAILLART, Lisa M.; NORMAN, Bryan A.; RAJGOPAL, Jayant. Dynamically optimizing the administration of vaccines from multi-dose vials. Iie Transactions, [S.L.], v. 46, n. 7, p. 623-635, 28 mar. 2014. Informa UK Limited. Disponível em: http://dx.doi.org/10.1080/0740817x.2013.849834. Acesso em: 11. jul. 2020.

MOURA, W.C.B. Avaliação de custos federais do Programa Nacional de Imunizações (Dissertação). Goiás (GO): Universidade Federal de Goiás; 2016.

PARMAR, Divya; BARUWA, Elaine M; ZUBER, Patrick; KONE, Souleymane. Impact of wastage on single and multi-dose vaccine vials: implications for introducing pneumococcal vaccines in developing countries. Human Vaccines, [S.L.], v. 6, n. 3, p. 270-278, mar. 2010. Informa UK Limited. Disponível em: http://dx.doi.org/10.4161/hv.6.3.10397. Acesso em: 05. jul. 2020.

PATEL, Prakash B.; RANA, Jayesh J.; JANGID, Sunil G.; BAVARVA, Neha R.; PATEL, Manan J.; BANSAL, Raj Kumar. Vaccine Wastage Assessment After Introduction of Open Vial Policy in Surat Municipal Corporation Area of India. International Journal Of Health Policy And Management, [S.L.], v. 5, n. 4, p. 233-236, 8 dez. 2015. Maad Rayan Publishing Company. Disponível em: http://dx.doi.org/10.15171/ijhpm.2015.208. Acesso em: 05. jul. 2020.

PEREIRA, Diego Daniel dos Santos; NEVES, Eduardo Borba; GEMELLI, Mauro; ULBRICHT, Leandra. Análise da taxa de utilização e perda de vacinas no programa nacional de imunização. Cadernos Saúde Coletiva, [S.L.], v. 21, n. 4, p. 420-424, 2013. FapUNIFESP (SciELO). Disponível em: http://dx.doi.org/10.1590/s1414-462x2013000400010. Acesso em: 12. jul. 2020.

PRAVEENA, Daya et al. Vaccine wastage assessment in a primary care setting in rural India. International Journal Of Contemporary Pediatrics, [S.L.], v. 2, n. 1, p. 7-11, 2015. Medip Academy. Disponível em: http://dx.doi.org/10.5455/2349-3291.ijcp20150202. Acesso em: 12. jul. 2020

RIO GRANDE DO SUL. Atlas Socioeconômico Rio Grande do Sul. 2018. Disponível em: http://www.atlassocioeconomico.rs.gov.br/regiao-metropolitana-de-porto-alegre-rmpa. Acesso em: 12. jul. 2020.

SETIA, Sabeena; MAINZER, Hugh; WASHINGTON, Michael L; COIL, Gary; SNYDER, Robert; WENIGER, Bruce G. Frequency and causes of vaccine wastage. Vaccine, [S.L.], v. 20, n. 7-8, p. 1148-1156, jan. 2002. Elsevier BV. Disponível em: http://dx.doi.org/10.1016/s0264-410x(01)00433-9. Acesso em: 05. jul. 2020.

UNICEF. United Nations International Children's Emergency Fund. Vaccine wastage assessment: field assessment and observations from national stores and five selected states in India. [Internet]. 2010. Disponível em: http://www.mofa.go.jp/mofaj/gaiko/oda/seisaku/kanmin/chusho_h24/pdfs/a20-12.pdf. Acesso em: 15. jun. 2020.

WORLD HEALTH ORGANIZATION. Global Vaccine action plan 2011-2020. World Health Organization, 2013. Disponível em: https://www.unicef.org/immunization/files/GVAP(1).pdf. Acesso em: 16. jun. 2020

______. Department of Immunization. Monitoring vaccine wastage at country level. Guidelines for programme managers. Vaccines and Biologicals Family and Community. Health World Organazition. Geneva, 2005.

______. World Health Assembly endorsed the Global Vaccine Action Plan and World Immunization Week. Geneva: WHO, 2014. Disponível em: http://www.who.int/immunization/newsroom/global_vaccine_action_plan/en/. Acesso em: 05. jul. 2020.

Published

2021-04-26

How to Cite

Mai, S., Rosa dos Santos, R. ., Herrmann, F. ., da Silva Carvalho, A. ., Celina Dezoti Micheletti, V., & Bordin, R. (2021). Financial cost of vaccine waste in the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil. Revista Eletrônica Científica Da UERGS , 7(1), 131–141. https://doi.org/10.21674/2448-0479.71.131-141

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Section

ARTIGOS INÉDITOS